Can my columellar scar be revised to appear less prominent? (photo)

Question

My surgeon apparently closed the scar with too much tension and it appears very textured and super noticeable. It's making me really insecure. I want to know if this scar can be revised and make it look less prominent. Thanks

Anna Chacon, MD, FAAD · Answer

Thank you for your message. I'm sorry to hear how much this scar has been affecting your confidence. You're not alone in this, and there are definitely ways we can work together to improve its appearance.

When a columellar scar (the area between the nostrils) heals with tension, it can result in texture irregularities or a more visible line. The good news is that there are both non-surgical and surgical options that can significantly improve how it looks, including:

Laser resurfacing to smooth out the texture and blend the scar with the surrounding skin

Microneedling with PRP to stimulate collagen remodeling and improve skin tone

Steroid or 5-FU injections (if raised) to reduce thickness or hardness

Surgical scar revision to re-excise and close the area more delicately under minimal tension

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Monika Kiripolsky, MD · Answer

Hi Bluey,
 Yes, this scar can be improved with a specific ablative laser treatment +/- a steroid/5-FU injection. Make sure you go to a board-certified physician who specializes in lasers. 
Hope this helps!
Dr. Kiripolsky

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Can my columellar scar be revised to appear less prominent? (photo)

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